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DIRECTOR OF QUALITY - Compliance Officer in Troy, Michigan at Custom Home Health Inc

NewJob Function: Human Resources
Custom Home Health Inc
Troy, Michigan, 48084, United States
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Job Description

Are you looking to join a team that values integrity, collaboration, and continuous improvement?

Position: Director of Quality/Compliance Officer – Home Health & Hospice

Reports to: CEO/Administrator

Location: Hybrid position

Responsibilities:

  • Lead agency-wide compliance and quality: oversee QA department, Quality Assurance & Performance Improvement (QAPI) initiatives, and Education/Training team.
  • Ensure adherence to all Medicare home health/hospice regulations (OASIS/PDGM, hospice benefit, QRP) and accreditation standards (e.g., ACHC, CHAP if relevant).
  • Manage all audits and surveys: plan for and respond to RAC/UPIC requests, state surveys, and internal reviews.
  • Oversee OASIS and HOPE/HIS data quality: review trends, error rates, and implement corrective action plans.
  • Develop, update, and enforce policies and procedures (Medicare CoPs, documentation requirements, compliance plans).
  • Conduct regular compliance training for clinicians (OASIS training, documentation accuracy, HIPAA).
  • Oversee Staff Orientation and education program: ensure staff continuing education, certification renewals, competency evaluations, and ongoing professional development in compliance with organizational and regulatory requirements.
  • Monitor Medicare denials and appeals: work with billing and clinical staff to correct systemic issues.
  • Collaborate with clinical leadership and the governing board on compliance strategy, reporting key metrics.

Qualifications (Must):

  • Certifications: OASIS (COS-C or HCS-O) and coding (HCS-D or HCS-H or CPC/CCS).
  • Experience: 5+ years in home health/hospice clinical or coding roles, with 2+ years in QA/compliance leadership.
  • Medicare Knowledge: Deep understanding of PDGM, HH PPS, Hospice Medicare rules, and documentation standards.
  • Education: Bachelor’s in nursing, preferred.
  • Licensed RN.
  • Management: Experience supervising teams (QA, education, coders). Strong policy development and analytical skills.

Preferred (Nice to Have):

  • Certifications: OASIS (COS-C or HCS-O) and coding (HCS-D or HCS-H or CPC/CCS).
  • Compliance/Quality certifications (e.g. CHC, CHPC, CPHQ).
  • Experience with HOPE implementation or Hospice Quality measures.
  • Prior success leading multi-disciplinary committees.

Job Location

Troy, Michigan, 48084, United States

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